James Rhodes is a British classical concert pianist who is known
for his iconoclastic, pop-inspired performing style. He is also an outspoken survivor of childhood
sexual abuse who is equally frank about his struggles with severe mental
illness. Rhodes’s memoir Instrumental
is a tribute to the healing power of music.
Indeed, music quite literally saves the author’s life; it is only when a
friend smuggles an iPod loaded with Bach into his psych ward that Rhodes
regains the will to live.

Rhodes does not mince words.
We learn that he was violently raped by a gym teacher on a regular basis
for five years from the age of five. Left with severe internal injuries that
produce wracking pain, he requires multiple surgeries. He soon also develops dissociative symptoms, drug
and alcohol addiction, self-injurious behaviors, and chronic suicidal ideation.
Barely able to function, he endures many tumultuous years during which he abandons
the piano. The author’s subsequent journey
from physical and emotional fragmentation to wholeness through music provides
the substance of his book.

The preface to Instrumental
is designated “Prelude,” and the ensuing twenty chapters, labeled “tracks,” all
correspond to musical works. (All twenty
tracks may be listened to, for free, on Spotify.) In addition, as if to assure
the reader he is in good company, Rhodes offers psychological profiles of famous
composers. We learn, for example, that Bruckner
suffered from a morbid obsession with numbers, and that Schumann, after
throwing himself in the Rhine, died in an asylum.

This memoir follows the journey of Nujood Ali, a young, Yemeni child bride from a rural village. She was later named Glamour's Woman of the Year in 2008.

The memoir begins with Nujood’s escape from her husband’s house and how she made her way—alone—to a courthouse in the country’s capital where she was determined to win a divorce.

Nujood’s father pulled her of school when she was in the second grade and forced her to marry a man much older than she. At this time, the minimum legal age of marriage for girls was 15, but many families—especially in rural areas—continued to engage in marrying off daughters much younger than this. Nujood’s father’s reasoning (which echoes the reasoning of many others who engage in this practice) included having one less child to feed, preventing Nujood from being raped by strangers, and protecting her from becoming the victim of “evil rumors.” (p. 54)

In a practice common in Yemen, her father moreover stipulated that Nujood’s husband would not have sex with her until she had begun to menstruate; the husband did not wait and instead raped Nujood after they were wed.

Throughout the book, Ali and French journalist Delphine Minoui skillfully explain how women are not given choices in Nujood's part of Yemen:

“In Khardji, the village where I [Nujood] was born, women are not taught how to make choices. When she was about sixteen, Shoya, my mother, married my father, Ali Mohammad al-Ahdel, without a word of protest. And when he decided four years later to enlarge his family by choosing a second wife, my mother obediently accepted his decision. It was with that same resignation that I at first agreed to my marriage, without realizing what was at stake. At my age, you don’t ask yourself many questions.” (p. 23)

Ali was connected with her lawyer, Shada Nasser, at the courthouse, and her case garnered both international attention and outrage. After a hearing, Ali was granted her divorce and took trips out of Yemen, including to the United States, even meeting with then Secretary of State Hillary Rodham Clinton. The memoir ends on a happy note, with Nujood starting her education again, at a new school, and definitively deciding to become a lawyer who is committed to raising the legal age of marriage in Yemen. The authors even discuss two cases of girls who were granted divorces in Yemen after Nujood and were able to use her case as legal precedence.

An article in the Huffington Post explains that while Nujood’s memoir ends on a happy and inspiring note, there is still much more work to be done. It points out that Nujood insisted on remaining in Yemen, while her American advocates believed it would be best for her and her future to remove her from her family. Nujood’s family put pressure on her to demand more and more financial compensation for her international fame. Even though her co-author and other advocates begged her to go to school, she did not complete her education. Her father used a (likely large) portion of her book proceedings to marry a third wife. The most recent update is that Nujood remarried (circumstances and consent unclear) and mothered two daughters of her own.

A rare patient narrative from 1812 describes a mastectomy performed before the introduction of anesthesia. This letter from Frances d'Arblay (1752-1840) (née Frances [Fanny] Burney), addressed to her older sister, Esther, details her operation in Paris by one of Napoleon's surgeons.In her childhood and youth, Fanny Burney moved in the best London society; she was a friend of Dr. Johnson who admired her. She served five years at the court of George III and Queen Charlotte as Second Keeper of the Royal Robes (1786-1791). Fanny Burney married Adjutant-General in the army of Louis XVI Alexandre-Jean-Baptiste Piochard d'Arblay in 1793. He had fled to England after the Revolution. They lived in England and spent ten years in France (1802-1812).Burney's mastectomy took place 30 September 1811. The patient wrote about her experience nine months later. She chronicles the origin of her tumor and her pain. She is constantly watched by "The most sympathising of Partners" (128), her husband, who arranges for her to see a doctor. She warns her sister and nieces not to wait as long as she did. At first resisting out of fear, the patient agrees to see Baron Dominique-Jean Larrey (1766-1842), First Surgeon to the Imperial Guard.He asks for her written consent to guide her treatment; her four doctors request her formal consent to the operation, and she makes arrangements to keep her son, Alex, and her husband, M. d'Arblay, away. Her husband arranges for linen and bandages, she makes her will, and writes farewell letters to her son and spouse. A doctor gives her a wine cordial, the only anesthetic she receives. Waiting for all the doctors to arrive causes her agony, but at three o'clock, "my room, without previous message, was entered by 7 Men in black" (136).She sees "the glitter of polished Steel" (138). The extreme pain of the surgery makes her scream; she feels the knife scraping her breastbone. The doctors lift her up to put her to bed "& I then saw my good Dr. Larry, pale nearly as myself, his face streaked with blood, & its expression depicting grief, apprehension, & almost horrour" (140).Her husband adds a few lines. These are followed by a medical report in French by Baron Larrey's 'Chief Pupil'. He states that the operation to remove the right breast at 3:45pm and that the patient showed "un Grand courage" (141). She lives another twenty-nine years. It is impossible to determine whether her tumor was malignant.

Dr. El Saadawi is an Egyptian feminist activist and a psychiatrist who originally published this book in Arabic in 1977. She has had a tumultuous relationship with the Egyptian government and was imprisoned after criticizing former President Anwar Sadat. During her career she worked at several universities in the United States. The Hidden Face of Eve: Women in the Arab World has seamlessly incorporated elements of memoir and critical analysis of Arab culture and Islam. El Saadawi divides the book into four sections: The Mutilated Half, Women in History, The Arab Woman, and Breaking Through. The book opens with Dr. El Saadawi recounting in the first-person her harrowing experience with female genital mutilation (a very common practice in her home country of Egypt) when she was 6 years old. She uses very descriptive, perhaps even graphic language, to describe the experience in all its horror. This early childhood memory sets the stage for the audience to bear witness to all the various types of misogyny that many Egyptian and Arab women inevitably experience.

Dr. El Saadawi then skillfully relates memories of being told, for example, to not ask too many questions because she was a girl, and states that she has never heard the word “bint” (Arabic word for girl) used in a positive fashion. These nuggets of personal experiences are inserted into an overview of the complaints of stifled sexuality and associated sequelae with which her psychiatric patients struggled. She delves into the topics of Islam’s take on non-marital sex, illegitimate children, and prostitution thrown against the backdrop of her personal experiences seeing young, poor girls who work as maids being raped and impregnated by the men of the families who employ them and then being held as the sole accountable party.

After the first section, Dr. El Saadawi broadens her focus to include the status of women starting with Eve (whom the major monotheistic religions, including Islam, believe to be the first woman on Earth). Dr. El Saadawi investigates the historical designation of women as inferior in the Jewish faith and explains that as Christianity and Islam evolved against this backdrop, they also assigned women to a similar status. She insightfully points out how femininity did not evolve independently of society but rather that femininity and a woman’s place in society (all societies) are direct reflections of socioeconomic practices or goals of that society.

Andrew Schulman is a New York
guitarist with a long history of playing in hotels, restaurants, small groups,
and formal concerts—even in Carnegie Hall, the White House, and Royal Albert
Hall. His memoir describes his experience as a patient in a Surgical Intensive
Care Unit (SICU), where he was briefly clinically dead. Six months later he
began a part-time career as a guitarist playing for patients and staff in that
very same SICU.

In July of 2009, Schulman underwent
surgery for a pancreatic tumor (luckily benign) but crashed afterward. He
suffered cardiac arrest and shortage of blood to his brain for 17 minutes.
Doctors induced a week-long medical coma, but his condition worsened. His wife
asked if he could hear music; he had brought a prepared iPod. When the opening
chorus of Bach’s St. Matthew Passion played in his earbud, the computer monitor
showed that his vital signs stabilized, and he survived. The nurses called it a
miracle.

Convinced of music’s healing power,
Schulman proposed that he return and play for patients and staff. He describes various
patients for whom he played over the next six years (with permission or changes
of name and details). He explains his approach to choosing music, pacing it, and
feeling hunches for what is right for a given patient. He interviews experts
and reads scientific papers in order to explain how the brain processes music. Music
reminds patients of their earlier, healthier lives; it coordinates right and left
brain; it brings calmness and peace.

Imaging studies show that music (and
emotionally charged literature) stimulate the brain regions associated with
reward—similar to euphoria, sex, and use of addictive drugs.

Schulman knew some 300 pieces from a
wide range of music, but his illness damaged his memory so that he could
recall only six of them. That meant his work relied on sheet music. Near the
end of the book, however, his “rehab” of playing three times a week, concentrating
on the music, and intending to help others—all this allowed his brain to heal, and
he began to memorize as before. Schulman consults with experts and undergoes
two brain scans and other studies that show the neuroplasticity of this brain
that allowed it to rewire and memorize once again.

Although Music Therapy is discussed
as an allied profession, Schulman is considered, rather, as a “medical musician” playing only in the SICU. Provision
of music, whether by Music Therapist or “medical musician,” is,
however, usually not covered by insurance and therefore not available to
patients.

There’s a six-page Afterword by Dr.
Marvin A. McMillen, who Schulman describes as “central” to his survival. McMillen
writes that being both a critical care doctor and a critical care patient himself
(polycystic kidney disease), he knows the importance of emotional support to
patients, healing environments, and the power of music. McMillen was also pivotal
in allowing Schulman to play in the SICU.

The subtitle is
accurate enough: “A Memoir of a Family and Culture in Crisis,” although the
author J.D. Vance is, in fact, the focal point of view throughout, from his
childhood to his success as an adult. Few young people made it out of the hills to enjoy stable and successful
lives, but J.D. was one of them, earning a degree at Ohio State University,
then a law degree at Yale. While recounting his life, he also describes
his relatives and neighbors, and he interprets the many dilemmas of his
hillbilly culture.
Vance was born
in 1984 and grew up in Jackson, Kentucky, a poor town following the collapse of
coal mining. His family was beset with poverty, alcoholism, mental instability,
and more. His mother had nine miscarriages and suffered from addictions; she
had multiple husbands. The culture around him suffered from domestic violence,
drug abuse, hoarding, unemployment, honor defended by fists, knives, or guns, as
well as bad financial habits, bad diets, obesity, lack of exercise, sugary
drinks, dental problems, and what he calls “emotional poverty.” There was welfare abuse and, in general “a
chaotic life.” He credits his grandparents, other relatives,
various teachers and professors for supporting him, guiding him, and comforting
him when he was hurt, angry, and/or confused.

Like many other
hillbillies, J.D. moved some hundred miles north into southern Ohio, where
steel companies provided jobs—that is, until they closed, like many other employers
in the Rust Belt. There also, hillbillies were left without income and social
problems increased. Stores and restaurants closed. Payday lenders and
cash-for-gold shops took their place. Drug dealers and users took over empty
houses.

After high
school, Vance joined the Marines. He credits the military for teaching him discipline,
persistence, and for developing his self-respect. For his success at Yale, he
thanks his professors, his girlfriend (later wife), and classmates for helping
him understand customs of New England society. One example: he leaves a banquet
to call his girlfriend; she instructs him on how to handle the nine pieces of unfamiliar
silverware surrounding his plate.

The last three chapters (11, 12, 13) and the conclusion analyze
his experience on more conceptual terms, including the “social capital” prized by the the New
England world, social instability of the culture he was raised in, and “adverse
childhood experiences” (or ACEs), the psychologists’ phrase for the damaging
events children experience in a culture of poverty, violence, and
limited futures. He writes that governmental child services have policies that
don’t understand the important roles of aunts, uncles, and grandparents in subcultures that rely on extended families. Indeed, faithful to his mother, he, as an
adult, provides specific help to her.

Talking with Doctors, a memoir by David Newman,
follows the author’s dizzying journey to find a physician and treatment plan after
being diagnosed with a rare malignant tumor perched dangerously near his brain
stem. Despite the author’s education, money, connections and geographic
privilege (Mr. Newman is a New Yorker surrounded by “the best” hospitals and
the “the best” doctors), he finds himself struggling to make any sense of the
conflicting medical advice he receives. The vertigo induced by the deluge of
advice he gathers in his countless trips to multiple medical centers, is only
exacerbated by the egotism and childishness of some of the doctors he sees. The
indecencies range from the routine—waiting hours for doctors that are running
behind schedule—to the utterly bizarre—a doctor returning Mr. Newman’s $10
copay as a gesture of good will after explaining that his tumor was inoperable
and would likely be fatal.
Mr.
Newman’s career as a psychotherapist is intimately interwoven into the fabric
of the memoir. His analytical eye strongly informs his search for a physician
whom he can trust. Moreover, knitted into the narrative is Mr. Newman’s
experience with his own patients whom he is forced to refer to other
therapists while he is receiving treatment.
Coloring
the tone of the entire memoir is the fact that Mr. Newman has survived the
tumor around which the memoir is framed. Nonetheless, Talking with Doctors is a harrowing and suspenseful read.

In 1942, Beth Pierce was completing her
internship in the new discipline of occupational therapy in a Baltimore hospital
where she meets Jim, a conscientious objector who is training to become a medic.
They share a love of poetry and the arts. He goes off to war and serves in the foxholes
and trenches of the dreadful conditions at the front. She stays in North
America serving in rehabilitation with the war wounded – young men damaged
physically and mentally from the great trauma. Until 1945, they exchange a
remarkable series of letters that describe the war, their parallel work with
the war wounded, their hopes for the future, and gratitude for each other’s
thoughts. The letters always close with “Please write.”

This memoir of a life in medicine takes the writer from
St. Louis to a Navajo reservation to Central America to the east coast and from
urban hospitals to ill-equipped rural clinics. It offers a wide range of
reflections on encounters with patients that widen and deepen his sense of
calling and understanding of what it means to do healing work. He learns to listen to tribal elders, to
what children communicate without words, to worried parents, and to his own
intuition while calling on all the skills he acquired in a rigorous medical
education. Always drawn to writing,
Volck takes his writing work (and play) as seriously as his medical practice, and
muses on the role of writing in the medical life as he goes along.

Paul Kalanithi, diagnosed with stage IV metastatic lung
cancer when he was a neurosurgery resident at Stanford University, was faced
with a decision. Should he truncate his career in neurosurgery in order to
become a writer - a career he had always envisioned for himself after completing
a couple of decades of neurosurgery practice? Married to Lucy Kalanithi, an
internist he had met in medical school, Paul’s career and future had looked
bright and promising. But as he entered his final year of a seven-year
residency, symptoms of excruciating back
pain and significant weight loss began. Garbed in a hospital gown, he examines
his own CT scan – this is how we meet Paul at the beginning of the Prologue. He
then writes of the relatively brief period of misdiagnosis prior to the CT scan. With the initial negative plain x-rays, he is started on nonsteroidal
anti-inflammatory drugs. But breakthrough pain and continued weight loss leads
to the CT. Paul the physician understands the death sentence the images
portend; Paul the patient is just beginning his journey. The diagnosis and
treatment cause him to reassess his decisions about his life, to decide to
father a child even though he knows he will never see the child grow up, and ultimately
to write a memoir, essentially for his daughter.

Paul had graduated from Stanford with undergraduate and
master’s degrees which reflected his dual love of literature and science. He combined these in a second master’s degree from Cambridge
University in the history and philosophy of science and medicine before
attending Yale for his medical degree. He and his wife return
to California for residencies. The book is largely a blend of his dual
interests: a deep and abiding love and faith in literature and how words can
reveal truths, and a passion for the practice and science of neurosurgery. The rupture of fatal illness into his life interrupts his dogged trajectory
towards an academic medical career, and, like all ruptures, confounds expectations and reorients priorities.

The book has five parts: a foreword by physician-writer
Abraham Verghese, who notes the stunning prose Paul produced for an initial
article in The New York Times and exhorts the reader to “Listen to Paul” (page
xix); a brief prologue; two parts by Paul Kalanithi (Part I: In Perfect
Health I Begin, and Part II: Cease Not till Death); and a stunning,
heart-breaking epilogue by Lucy Kalanithi. In the epilogue, written with as
many literary references and allusions as her husband’s writing includes, Lucy
provides the reader with a gentle and loving portrait of her husband in his
final days, reaffirms his joy in their daughter Cady, and chronicles how she
kept her promise to her dying husband to shepherd his manuscript into print.

The bulk of the book is memoir – a childhood in Arizona and
an aversion to pursuing a life in medicine due to his hard-working cardiologist-father,
experiences at Stanford which eventually led him to reverse his decision to
avoid a medical career, the stages of his medical career and caring for
patients, and his devastating cancer. Though initially responsive to
treatment—and indeed, the treatment enables him to complete his residency and
decide to father a child with Lucy—the cancer is, as prognosticated from the diagnosis, fatal.

What makes this memoir so much more than an exercise in
memory and a tribute to the herculean effort to write while sapped by cancer
and its treatment, are the philosophical turns, the clear love of words and
literature, and the poignancy of the writing. He begins reading fiction and
nonfiction again: “I was searching for a vocabulary with which to make sense of
death, to find a way to begin defining myself and inching forward again. The
privilege of direct experience had led me away from literary and academic work,
yet now I felt that to understand my own direct experiences, I would have to
translate them back into language…I needed words to go forward.” (pp 148-9)
Paul’s writing ends with what is arguably some of the most
poetic prose ever written. He concludes by speaking directly to his infant
daughter: “When you come to one of the many moments in life where you must give
an account of yourself, provide a ledger of what you have been, and done, and
meant to the world, do not, I pray, discount that you filled a dying man’s days
with a sated joy, a joy unknown to me in all my prior years, a joy that does
not hunger for more and more but rests, satisfied. In this time, right now,
that is an enormous thing.” (p. 199)